Really high would you do more insulin?

Hey Donna

Personally if it was me I'd wait a while longer. Typically quick acting insulin last for 4 hours so if you correct with more quick acting you have a chance of running hypo after. Hope I was of some help.

Hi Donna. Has this happened before ? Did you inject for the bread ? I don't like telling people to adjust their medication but keep testing and should come down soon. The main thing is to try to discover why this happened to prevent it occurring again. A one off high won't hurt. Good luck.
Mo


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DonnaC-T said:

Hi
It's two and a half hours after eating, I only had a slice of bread, I was 5.6 and now I'm 16.4!
Would you do a little more insulin, it's almost three hours since my jab.
Thanks x

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That's a big jump in bg for one slice of bread Donna. I know it's a bit late but if that was a one-off reading then I wouldn't worry about it as it might mean that your insulin didn't absorb properly or you might be coming down with something, if it's a common occurrence then you need to look at why your levels went so high and look at the foods that you eat for example.

There's a meter that you can get through your diabetes clinic called the Accu-Chek Aviva Expert, it advises on bolus doses taking into account the food you eat, insulin to carb ratio's, stress, illness, exercise and how much IOB (insulin on board) you have in your system when bg testing, I'm almost certain at 16.4 two and a half hours after eating it would have recommended a correction dose, worth enquiring about if you don't have the meter already or similar!

You need to work out how much one unit of bolus will typically drop your BG. For me it's quite an important bit of info (as much as insulin to carb ratio) and I find it particularly important when I get a random high result or I'm ill as it lets me work out how much more to inject.

DonnaC-T said:

Still 15 so I'll do extra insulin. I normally do 6 so 8/10?
Oh I don't know???

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Use the 100 Rule Donna, divide 100 by your TDD (total daily dose). So if you inject 30 units of insulin then 1 unit of insulin should lower your bg by 3.3mmol/l, it's not precise but it does work in most cases.

DonnaC-T said:

I am so thick at all this, it's never been mentioned before other than you guys. So I do 8, 6,16 and 20. I presume that includes long and short?
So 1 unit should lower it by 2, roughly?
I'm hoping they go through all this on the carb course. I spend most of my days utterly confused, luckily no one has noticed a difference

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Yeah you've got it :thumbup:

As I say the 100 Rule isn't always precise and much can depend on the time of day, some find they are more sensitive to insulin in an evening than they are early morning so testing is the key to getting your correction dose right.

btw your not thick at all and your just learning like everyone else is, no-one has all the answers as diabetes is such a complex condition. It's great that we have forums like this one whereby we can all share ideas and learn from one-another.

I got my copy of Think like a Pancreas from Amazon Donna, always found them to provide a first-class service whatever I order.

Here's a good store to get Think like a pancreas from http://www.bookdepository.com/search?se ... =Find+book

Where ever you get it from - it's a fab book!

DonnaC-T said:

And I am really grateful for all the help. The thing is I've had this for 18 years and have never been told about correction or basal/ bolus or anything. I practically had to beg my nurse to refer me for a course.
I've been trying so hard to be good after 18 years of not bothering and I feel so much worse.
I will do this, it won't beat me. I'm at 6.6 at the mo so much better.
You all sound so knowledgable.
I read about the book 'Think like a pancreas' I think I'll get that and have a read.
Thanks so much x

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I only found out about insulin to carb ratios and using a correction factor to lower high bg levels through logging on to the BDEC carb counting website which explained how to go about using the 100 rule. For many years I stayed under the care of a GP and just saw a DSN every 6 months who was lovely but still didn't explain about carb ratios or corrections. To this day, I still haven't done the DAFNE course but didn't think I needed to anyway as I had more or less worked everything out myself from using BDEC and looking at some of the links posted on the forum about adjusting insulin according to the time of day food is eaten as ratios need to be changed and testing bg levels more frequently than what I was doing.

Re the 100 rule, to get a basic average of what the TDD insulin really is, its best to add up 7 days worth of insulin doseage and then divide that by 7 and whatever that amount is, then divide into 100 to get a basic correction factor and try by testing bg levels every 2hrs to work out a good insulin to carb ratio that will enable you to have safe bg levels throughout the day like 6mmol before food and then something like 8.5mmol 3hrs later and then by the time 4-5hrs has gone bg levels should be back around 5-7mmol before food again. If a correction is needed only do it 3hrs later and only if its as high as 10-15mmol as leaving it although it will get lower, I doubt whether it would be low enough to be back at a good level but caution has also got to be used as sometimes using the correction factor at the 3hr mark wont take into account that the bolus is only going to last 4-5hrs so manually using some degree of guesswork, you should probably half whatever the bolus correction is but that's where using a carb wizard comes in handy as it will do all the calculations for you instead of you having to work it all out yourself.

Although there are bg meters available that have carb wizards on them, if you haven't got one, then you can download carb wizards from the internet and use them. Some are available as an app for mobile phone use. I sometimes fall back on a very good carb counting wizard website called ManageBGL which can also be used as an app. To find out how it works, you might be able to see youtube videos on it but everything is explained through joining and then having a read.


From reading your message although the bg level you posted might be just a flash in the pan, it might also mean that you've either not counting the carb correctly or if you have, then you will need to think about adjusting the insulin in the carb ratio so that your bg levels are not going as high especially if it goes on for more than 2 days and its not because you have an infection brewing (although if you have, you still need to alter the insulin and then alter it back once the cause of the high has gone).


Good luck with everything anyway and don't worry there are loads of diabetics just like yourself (I was one of them)...

Hi Donna, go for a walk even if for 15 mins, will reduce blood sugar reading